Mayo Clinic Q&A

From complex or serious conditions like cancer and heart disease to the latest news on research and wellness, host Dr. Halena Gazelka asks the questions and gets easy-to-understand answers from Mayo Clinic experts

Most Recent Episodes

man running in the sun, wearing a hat for protection, crossing a bridge

Protect your skin from the summer sun
August 19, 2022

Whether swimming in the pool, a trip to the lake or a day at the beach, summertime often means sun exposure. And protection from the sun is the focus of Summer Sun Safety Month every August.

Skin cancer is the abnormal growth of skin cells. While it most often develops on skin exposed to the sun, but it also can occur on areas of skin not ordinarily exposed to sunlight. Skin cancer is the most common form of cancer in the U.S.

"And the incidence of skin cancer is rising," says Dr. Dawn Davis, a Mayo Clinic dermatologist. “We all want to be on the Earth longer, and we appreciate time and aging. But the older we are, the higher our risk for skin cancer.” 

The three major types of skin cancer are basal cell carcinomasquamous cell carcinoma and melanoma. Early detection of skin cancer gives you the best chance for successful skin cancer treatment.

While it is common to have freckles and moles develop over time, it is important to know your skin and recognize when changes occur.

"It's important to know what skin lesions you have," explains Dr. Davis. "Know what they look like, so that if they change, you can come to the dermatologist or health care provider for evaluation."

Melanoma is the most serious and deadly form of skin cancer. Dr. Davis says the "melanoma alphabet" can help with early detection:

  • Asymmetry 
    Look for moles with irregular shape.
  • Border 
    Look for moles with irregular, notched or scalloped borders.
  • Changes in color 
    Look for growths with different or uneven colors.
  • Diameter 
    Look for new growth of more than one-quarter of an inch in diameter.
  • Evolving 
    Look for changes over time.

While melanoma is more common with age, pediatric melanoma can occur.

“Often, it's not on everyone's radar because we don't believe that children can have skin malignancy, but that is not true,” says Dr. Davis. “It's simply less common. When children get melanoma, they can present with the same signs and symptoms as adults. However, they can also have different symptoms. Pediatric melanoma tends to be skin-colored or amelanotic more commonly than dark or pigmented. So, if a child develops a skin-colored, pink or red bump, or something that used to be flat and then becomes raised, that would be of concern.” 

On the Mayo Clinic Q&A podcast, Dr. Davis discusses skin cancer detection and treatment. Dr. Davis also recommends steps to take to protect your skin including avoiding ultraviolet rays, and wearing sunscreen and protective clothing.

older couple, man and woman hiking using hiking sticks

What happens after colorectal cancer treatment?
August 12, 2022

While colorectal cancer is still the third leading cause of cancer deaths in the U.S., continuing improvements in screening and treatment mean many people diagnosed with colorectal cancer now can expect to survive long after diagnosis. 

The American Cancer Society estimates there are more than 1.5 million survivors of colorectal cancer in the U.S. 

But what happens after treatment for colorectal cancer is complete? Do survivors of colorectal cancer return to life as they knew it before their diagnosis?

"I think there are three main things that I see our patients really concerned with when they start thinking about finishing their treatment for colorectal cancer," says  Dr. David Etzioni, a colorectal surgeon and chair of the Department of Surgery at Mayo Clinic in Arizona. "The first and biggest concern they have is whether or not their disease will completely go away and stay gone. And this is, I think, a fundamental concern for any patient treated for cancer of any kind." 

Dr. Etzioni explains the other two common concerns for survivors of colorectal cancer are how the treatment will affect their day-to-day quality of life, and whether or not they will need an ostomy bag temporarily or permanently.

An ostomy is a surgically created opening in your abdomen that allows waste or urine to leave your body and be collected in a bag or pouch. For survivors of colorectal cancer, this may be temporary to give the colon time to heal. But, depending on the extent of surgery to remove the cancer and the location of the cancer, sometimes a permanent ostomy bag is needed.

Dr. Etzioni says education can alleviate the fears patients have about needing an ostomy bag.

"When I do have a patient who's worried what the bag is and what it might mean for their life — it might be a temporary or permanent bag — we have a lot of educational resources here at Mayo available to them. We often will send them to our osteo nurses, so they can actually try just wearing the appliance before they've undergone the surgery. They can see what it might be like to wear that underneath their clothes," explains Dr. Etzioni. 

"We also have a support group that consists of patients who have an ostomy. They discuss with each other what challenges they faced, and they're very supportive with each other. And I have a group of patients who are now with an ostomy who I can call on to reach out to a new patient of mine and talk about what it might mean to live with an ostomy. And that's something that I found to be very effective and can really help patients to get over that hump to accept that possibility for cancer treatment."

Finally, Dr. Etzioni says the support of family, friends and loved ones is an important part of the journey for patients with colorectal cancer.

"The patients who undergo treatment with a strong, consistent, omnipresent support system, they simply do better — not just emotionally, but also just in terms of the ability to tolerate treatment," says Dr. Etzioni. "I think they literally have better medical and surgical outcomes."

On this Mayo Clinic Q&A podcast, Dr. Etzioni discusses what people can expect after colorectal cancer treatment ends, and how to achieve the best possible quality of life.

three girls, soccer players, smiling

Fueling the young athlete
August 12, 2022

When it comes to sports and activities, what a child eats can affect performance. Sports nutrition focuses on not only on good eating habits, but also on what an athlete might need before exercising and after as a part of recovery. 

Of course, sports nutrition goes beyond simply what you eat. When you eat is important, too. 

Understanding the right balance and timing of taking in carbohydrates, proteins and hydration can help athletes play their best. Eating a healthy diet ensures that athletes are getting all the nutrients their bodies need to produce energy to perform and to keep muscles, bones, joints and tendons healthy.

Parents and kids should know the basics of sports nutrition and understand how supplements work and which products are beneficial. They also should be wary of supplements and products marketed to athletes because many products do not live up to their claims to increase strength, speed, and athletic skills. 

"Before you even consider supplement, you've got to make sure your diet and the foundation of that diet is solid," explains  Luke Corey, a registered dietician and sports medicine expert with by Mayo Clinic Children’s Center. "What I tell my athletes is that unless you have a solid diet in place, eating every couple of hours consuming nutrient dense foods hydrating, well, supplements are not going to do for you what you think they're going to do." 

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Luke Corey to discuss sports nutrition for young athletes. Topics discussed include what to eat before and after a workout; supplements and drinks including protein, creatine, electrolytes, and pre-workout caffeinated drinks; and concerns about calorie restrictive diets for athletes in some sports including wresting and gymnastics.

Girl on a swing, in a park

Managing childhood asthma
August 9, 2022

Asthma is a lung condition that causes swelling of the airways. It can make breathing difficult and trigger coughing, wheezing and shortness of breath. It's the most common chronic disease among children, although it affects adults, as well. 

More than 262 million people globally are affected by asthma, and more than 461,000 have died due to the disease, according to the World Health Organization.

In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers, such as inhaling pollen or catching a cold or other respiratory infection. Childhood asthma can cause bothersome daily symptoms that interfere with play, sports, school and sleep. In some children, unmanaged asthma can cause dangerous asthma attacks.

Childhood asthma isn't a different disease from asthma in adults, but children face unique challenges. The condition is a leading cause of emergency department visits, hospitalizations and missed school days.

Unfortunately, childhood asthma can't be cured, and symptoms can continue into adulthood. But with the right treatment, children can keep symptoms under control and prevent damage to growing lungs. Maintaining good day-to-day asthma control is the key to keeping symptoms at bay and preventing asthma attacks.

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center expert, Dr. Manuel Arteta, a pediatric pulmonologist, to discuss asthma in children.

Mother-breastfeeding-her-newborn-baby-beside-window.

Practical approaches to breastfeeding
August 5, 20222

Breastfeeding can be challenging, but help is available for new mothers. Lactation consultants, either at the hospital or through organizations like La Leche League, can help with learning the positions that work best mom and baby, and offer tips that can help with learning this new skill of breastfeeding.

While breastfeeding benefits for the baby are well-known, the mother also benefits.

"It's definitely a great healthy choice for moms to breastfeed," explains Rebekah Huppert, a lactation consultant and nurse at Mayo Clinic. "We know that with breastfeeding, we see a reduction in mom's risk for cancer, primarily breast and ovarian cancer; we see a reduced risk for diabetes; and a reduced risk for cardiovascular issues later in life. It can help reduce bleeding right after delivery by causing some contractions of the uterus. Evidence that shows that breastfeeding helps with weight loss, as well. It just takes a lot of calories to make breast milk, so we burn through those quickly when we're lactating. Those are just a few of the benefits, but they're big ones for moms."

The American Academy of Pediatrics recommends exclusive breastfeeding of infants for the first six months of life before introducing nutritious complementary foods. The organization also encourages social and systemic changes to support mothers who choose to breastfeed.

This summer, the American Academy of Pediatrics released new recommendations supporting mothers to continue breastfeeding for two years or beyond. These recommendations align with guidelines provided by the World Health Organization and the American Academy of Family Physicians. 

Huppert advises women to not feel undue pressure with these new guidelines.

"It's a sensitive topic for women, especially those who want to do more and find that their body isn't cooperating or sometimes their job isn't accommodating," says Huppert. "So it is important to make sure that moms know that there are multiple ways we nourish our babies. We nourish them by holding them, and by talking to them and reading to them. It isn't just food. And at the end of the day, maternal health — having a mom who is happy and healthy — is going to be the most important thing for a child's growth and development." 

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center lactation expert Rebekah Huppert to discuss practical approaches to breastfeeding.

Man, wearing stocking hat, looking at sunrise over bluffs

Cancer rehabilitation
Aug. 2, 2022

Cancer rehabilitation is available before, during and after cancer treatment. It helps people with cancer maintain and restore physical and emotional well-being, cope with the side effects of cancer, and recover more quickly and more fully from cancer treatment.

Cancer rehabilitation involves many types of specialists working together to develop a personal rehabilitation plan that considers a person's preferences, strengths and goals.

"Cancer rehabilitation aims to help patients maintain function, restore function, and, more broadly, maintain personhood," says Dr. Andrea Cheville, a Mayo Clinic specialist in physical medicine and rehabilitation. "We obviously don't want the process of curing cancer to leave patients with lasting issues that are going to compromise the quality of their life." 

Cancer rehabilitation can include help from a wide variety of specialists, including physical medicine and rehabilitation, physical and occupational therapy, speech and language pathologists, and psychologists. 

"All these specialists work in close partnership to develop an individualized program for each unique individual that meets their needs, goals and preferences," explains Dr. Cheville.

Dr. Cheville encourages people with cancer to include their family and caregivers in the cancer rehabilitation process. It is important for caregivers to understand the patient's goals and can support the work needed to reach them.

"The ideal for a cancer rehab team is the full engagement of the caregiver or partner," says Dr. Cheville. " It truly is a partnership and a team effort."

On the Mayo Clinic Q&A podcast, Dr. Cheville discusses what's involved in cancer rehabilitation and how it can help people with cancer cope with the challenges that come with cancer diagnosis, treatment and recovery.

Tim and Carly Kelly, with their bikes, preparing for the Transplant Games of America

Father-daughter duo taking part in Transplant Games of America
July 29, 2022

Carly Kelly was born with autosomal recessive polycystic kidney disease, a disease that not only affects the kidneys, but also can lead to liver problems. She spent the first month of her life in the Neonatal ICU at Mayo Clinic, where physicians told Carly's family she would eventually need a kidney transplant. 

"I was the first one to register as a donor," says Tim Kelly, Carly's father. "And I was so blessed to be a match. Carly and I have the exact same blood type: AB negative. There are so many people out there that are waiting for kidney and other organs. It is such a long waitlist, and to be able to give my daughter a kidney right off the bat was so fortunate for both of us."

At age 8, Carly had her first organ transplant, receiving a kidney from her father. In 2019, Carly went into liver failure she received a liver transplant on May 2, 2019. 10 months later, Carly received her second kidney transplant. All three transplants have taken place at Mayo Clinic in Rochester, Minnesota.

Now 27 years old, Carly is doing well and hasn't let her transplants slow her down. She and her father will compete in the 2022 Transplant Games of America, which will take place July 29-Aug. 3 in San Diego. The games are open to transplant recipients, living donors and donor families in different categories.

Carly and Tim will be part of Team MN-DAK, which is sponsored by LifeSource. This will be their third time competing in the games, taking part in cycling, pickleball and cornhole. They've been preparing together for the event.

"Every day, we'll bike, or we'll go for a walk, or we'll play pickleball or we'll throw some bags," says Carly. "Being together and preparing, it's something just my dad and I do, which is really cool. It's not really about competing. It's more about honoring your donor." 

There are nearly 106,000 people in the U.S. waiting for a lifesaving organ transplant. Tim and Carly both say that competing in the games is not only about honoring the donors, but also raising awareness. 

"Please registered to be a donor," implores Tim. "One person can save up to eight lives. And it's easy thing to do. Carly wouldn't be here without multiple donors." 

To register to be a donor, visit the Donate Life America website

On the Mayo Clinic Q&A podcast, Carly and Tim Kelly share their story.

a small glass filled with prescription medication pills

Combatting drug shortages
July 26, 2022

Drug shortages continue to be a major health care issue in the U.S., with more than 200 ongoing and active shortages per year since 2018. 

"Drug shortages are not new to health care," explains Dr. Mary Gilmer, director of pharmaceutical supply and procurement for Mayo locations across the Midwest. "But, really, over the last two years with the COVID-19 pandemic, the shortages have really exposed the vulnerability of our global drug supply chain. And these drug shortages remain high, despite decades of continued and increased awareness, effort and significant resource investment in these drug shortage programs at the highest level." 

At Mayo Clinic, the Pharmacy and Theruapuetics Committee has strategies and an organized approach to managing each drug shortage that's encountered.

"We engage our staff right down to the front-line team members when we're experiencing a shortage," says Dr. Gilmer. "When we place an order for a medication, and we do not receive sufficient quantities of what we're needing to take care of our patients, that's when we start escalating it, and really coordinating around how we understand and identify shortages so that we can best proactively manage them. So that's getting everybody on board for awareness, and any changes in our electronic health system that we need — or engaging our formulary colleagues to understand what alternatives or substitutes we can use." 

In addition to work done internally, Mayo Clinic also has taken a leadership role in combating drug shortages across the U.S., including joining the End Drug Shortages Alliance. The coalition is a collaboration of health system, supply chain and industry partners seeking to prevent drug shortages by solving pharmaceutical supply challenges and increasing transparency.

Mayo was also a founding member of Civica Rx, a nonprofit generic drug company whose goal is to reduce shortages of essential medications that hospitals use. Civica Rx recently announced plans to manufacture and distribute affordable insulin. 

"We often talk about mitigating the impact of a drug shortage, but our goal is really to get further upstream and actually end them and stop them from happening,"says Dr. Eric Tichy, chair of the Division of Pharmacy Supply Solutions at Mayo Clinic. "So we do a lot of advocacy with the government and different regulatory agencies. And anytime someone says they want to help end or manage drug shortages, we're always interested in what that opportunity is."

On the Mayo Clinic Q&A podcast, Drs. Gilmer and Tichy discuss Mayo Clinic's work to combat drug shortages.

Group of young girls, one smiling at camera

Ask the Mayo Mom: Managing heavy menstrual cycles and demystifying treatment options
July 22, 2022

The menstrual cycles for adolescents vary significantly, including the age at which the first period begins. Frequency, length of period, and amount of bleeding also vary widely.

"The factors that define when you're going to get your first period really is when did mom get her first period, so genetic factors, but there are a lot of lifestyle factors, too" says Dr. Asma Chattha, chair of Pediatric Gynecology at Mayo Clinic. "Definitely weight gain and rate of weight gain plays into it as well. New research is suggesting socio-economic factors and adverse childhood experiences also affect when you get your first period. So that's probably why there's such a variation and when you'll first get your period."

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia.

While what's considered normal covers a wide range, heavy bleeding during menstrual cycles can be a concern. In these cases, teens and their parents should reach out to their health care team for an evaluation.

"From a hematology standpoint, we always worry that there's some kind of predilection to bleeding," explains Dr. Asmaa Ferdjallah, a Mayo Clinic pediatric hematologist. "And there's a few inherited bleeding disorders that are not that uncommon in the population, honestly. And sometimes their only presentation is heavy periods. At times, many of these girls and young women go their whole life, and they just don't know that they have these deficiencies, or bleeding propensities, and those are fairly easy to screen for."

Another common issue is menstrual cramps

Menstrual cramps, or dysmenorrhea, are throbbing or cramping pains in the lower abdomen. Many girls and women have menstrual cramps just before and during their menstrual periods.

For some, the discomfort is merely annoying. For others, they can be severe enough to interfere with everyday activities for a few days every month. Menstrual cramps that aren't caused by another condition tend to lessen with age and often improve after giving birth.

There are hormonal and non-hormonal treatment options and products to help girls and young women cope with heavy periods.

"I know it's hard to talk about these things, but talk to your health care team with any question you have about heavy periods," says Dr. Ferdjallah. "Ask all your questions. None of them are dumb, and we will do our best to help you. More often than not, we can find you a solution to make your periods better." 

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, a Mayo Clinic pediatrician, is joined by Mayo Clinic Children’s Center experts Drs. Chattha and Ferdjallah to discuss misconceptions about, and treatment options for, heavy menstrual cycles.

More resources:

Dads, daughters and talking about menstruation — advice from an expert.

Medical illustration of lumbar puncture

Liquid biopsy can help guide cancer treatment
July 19, 2022

When cancer spreads from its original location to other parts of the body, it has metastasized. Central nervous system metastases occur when cancer cells spread from their original site to the brain and spinal cord. 

Any cancer can spread to the central nervous system, but the types most likely to cause such metastases are lung, breast, colon and kidney cancers, and melanoma.

Treatment for brain and spinal cord metastases can help ease symptoms, slow tumor growth and extend life. 

To determine which treatment might work best for a person's tumor type, some health care professionals now use liquid biopsies. When a metastatic tumor is in a place in the body that cannot be reached through surgery for a tissue biopsy, liquid biopsies are especially helpful.

A liquid biopsy involves collecting fluid and analyzing it for tumor biomarkers that can help health care professionals determine the tumor's molecular structure and individualize treatment for the best outcome. 

"So we have excellent drugs for different cancer types that are really based off of your specific cancer," explains Dr. Wendy Sherman, a Mayo Clinic neurologist. "So, not just your lung cancer, but does your lung cancer have a specific mutation? And there are drugs that match up to the mutation that have been very effective."

Dr. Sherman explains that halfof the time when a cancer travels to a different part of the body, particularly to the brain, the cancer may change and lose its mutation. 

"So, if you treat someone based off of the information that you had a couple years ago from where the cancer started, that may not reflect the current state of your cancer and what it looks like," says Dr. Sherman. And, so, our treatment really depends on that. And with a lot of these new-generation treatments that are going after these mutations, it has been very beneficial to look for those in the spinal fluid. And it absolutely has improved how people deal with this from a symptom standpoint because we're often able to give them often drugs that are better tolerated because they're more targeted."

Research is underway to further expand the use of liquid biopsies.

"We want to learn more about the use of liquid biopsy, particularly as it pertains to spinal fluid for not just brain metastases but also for cancers that start in the brain," explains Dr. Sherman. "And then also, can we use other fluids in the body? Those samples — urine and blood — are being collected and tested so that hopefully we can make progress toward that use."

On this Mayo Clinic Q&A podcast, Dr. Sherman discusses the use of liquid biopsy in caring for people with breast, lung and gastric cancer that has spread to the brain and spinal cord.